A hypermutation phenotype and somatic MSH6 mutations in recurrent human malignant gliomas after alkylator chemotherapy.


Journal Article

Malignant gliomas have a very poor prognosis. The current standard of care for these cancers consists of extended adjuvant treatment with the alkylating agent temozolomide after surgical resection and radiotherapy. Although a statistically significant increase in survival has been reported with this regimen, nearly all gliomas recur and become insensitive to further treatment with this class of agents. We sequenced 500 kb of genomic DNA corresponding to the kinase domains of 518 protein kinases in each of nine gliomas. Large numbers of somatic mutations were observed in two gliomas recurrent after alkylating agent treatment. The pattern of mutations in these cases showed strong similarity to that induced by alkylating agents in experimental systems. Further investigation revealed inactivating somatic mutations of the mismatch repair gene MSH6 in each case. We propose that inactivating somatic mutations of MSH6 confer resistance to alkylating agents in gliomas in vivo and concurrently unleash accelerated mutagenesis in resistant clones as a consequence of continued exposure to alkylating agents in the presence of defective mismatch repair. The evidence therefore suggests that when MSH6 is inactivated in gliomas, alkylating agents convert from induction of tumor cell death to promotion of neoplastic progression. These observations highlight the potential of large scale sequencing for revealing and elucidating mutagenic processes operative in individual human cancers.

Full Text

Duke Authors

Cited Authors

  • Hunter, C; Smith, R; Cahill, DP; Stephens, P; Stevens, C; Teague, J; Greenman, C; Edkins, S; Bignell, G; Davies, H; O'Meara, S; Parker, A; Avis, T; Barthorpe, S; Brackenbury, L; Buck, G; Butler, A; Clements, J; Cole, J; Dicks, E; Forbes, S; Gorton, M; Gray, K; Halliday, K; Harrison, R; Hills, K; Hinton, J; Jenkinson, A; Jones, D; Kosmidou, V; Laman, R; Lugg, R; Menzies, A; Perry, J; Petty, R; Raine, K; Richardson, D; Shepherd, R; Small, A; Solomon, H; Tofts, C; Varian, J; West, S; Widaa, S; Yates, A; Easton, DF; Riggins, G; Roy, JE; Levine, KK; Mueller, W; Batchelor, TT; Louis, DN; Stratton, MR; Futreal, PA; Wooster, R

Published Date

  • April 15, 2006

Published In

Volume / Issue

  • 66 / 8

Start / End Page

  • 3987 - 3991

PubMed ID

  • 16618716

Pubmed Central ID

  • 16618716

International Standard Serial Number (ISSN)

  • 0008-5472

Digital Object Identifier (DOI)

  • 10.1158/0008-5472.CAN-06-0127


  • eng

Conference Location

  • United States